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Relationship Between Clinical and Laboratory Findings and Hospital Admission in Cellulitis Patients Presenting to the Emergency Department

Yıl 2026, Cilt: 23 Sayı: 1 , 132 - 138 , 27.03.2026
https://doi.org/10.35440/hutfd.1800489
https://izlik.org/JA33MY98SL

Öz

 Background: Cellulitis is a bacterial infection of the skin and subcutaneous tissues and represents a substantial proportion of emergency department visits. This study aimed to identify independent clinical and laboratory predictors of hospitalization among cellulitis patients presenting to a tertiary emergency department.

Materials and Methods: Adult patients (≥18 years) diagnosed with cellulitis between January 1, 2019, and January 1, 2025, were retrospectively analyzed. Demographic, clinical, and laboratory parameters were evaluated. Multivariable logistic regression analysis was performed to determine independent predictors of hospitalization. ROC analysis was performed for variables retained as independent predictors in the multivariable model.

Results: A total of 162 patients were included. The mean age was 51.1±19.3 years, and 57.7% were male. Overall, 52.5% of the patients (n=85) were hospitalized, while 47.5% (n=77) were managed as outpatients. Among the comorbidities, diabetes mellitus (22.1%) and hypertension (16.6%) were prominent. Inflammatory markers were significantly higher in hospitalized patients (p<0.05, for all). In multivariate logistic regression analysis, C-reaktif protein (CRP) [odds ratio (OR): 1.06; 95% confidence interval (CI): 1.00-1.12; p=0.033], hemoglobin (OR: 0.75; 95% CI: 0.59-0.95; p=0.016), and platelet count (OR: 0.995; 95% CI: 0.991-0.999; p=0.014) were identified as independent predictors of hospitalization. In the ROC analysis, CRP was found to have the highest AUC value (AUC=0.692; 95% CI: 0.608-0.776; p<0.001).

Conclusions: CRP was found to be an independent predictor of hospitalization in patients with cellulite. Laboratory parameters added to the clinical evaluation can provide a supportive risk classification in the hospitalization decision.

Etik Beyan

The study was prepared in accordance with the Declaration of Helsinki and, since it was a retrospective study, it was conducted after obtaining the necessary permission from the Chief Physician of Harran University Hospital and the Ethics Committee.

Destekleyen Kurum

There is no institution that receives support.

Kaynakça

  • 1. Wiederhold AK, Cartuliares MB, Jeppesen K, Skjøt-Arkil H. Characteristics and antibiotic treatment of patients with cellulitis in the emergency department. Antibiotics (Basel). 2024;13(11):1021.
  • 2. Burian EA, Karlsmark T, Franks PJ, Keeley V, Quéré I, Moffatt CJ. Cellulitis in chronic oedema of the lower leg: an international cross-sectional study. Br J Dermatol. 2021;185(1):110-8.
  • 3. Lin V, Callado GY, Pardo I, et al. Diagnostic stewardship and dermatology consultation in cellulitis management: a systematic literature review and meta-analysis. Arch Dermatol Res. 2025;317:61. doi:10.1007/s00403-024-03515-x.
  • 4. Taira K, Wang M, Guo W, Kam O, Kaufmann T. Association of cellulitis with obesity: systematic review and meta-analysis. JMIR Dermatol. 2024;7:e54302.
  • 5. Nightingale R, Yadav K, Hamill L, et al. Misdiagnosis of uncomplicated cellulitis: a systematic review and meta-analysis. J Gen Intern Med. 2023;38(10):2396-404.
  • 6. Cutler TS, Jannat-Khah DP, Kam B, Mages KC, Evans AT. Prevalence of misdiagnosis of cellulitis: a systematic review and meta-analysis. J Hosp Med. 2023;18(3):254-61.
  • 7. Jacka J, Sierla R, Kilbreath SL, Dylke ES. A systematic review of cellulitis guidelines: the role of non-pharmacological management in preventing recurrence. Australas J Dermatol. 2025;66(6):321-8.
  • 8. Özçelik MN, Sayar MS, Aydın NN, et al. Clinical and inflammatory predictors of outpatient treatment failure in uncomplicated skin and soft tissue infections: a prospective multicenter study from Türkiye. BMC Infect Dis. 2025;25(1):1744.
  • 9. Raff AB, Kroshinsky D. Cellulitis: a review. JAMA. 2016;316(3):325-37.
  • 10. Dennis L. Stevens, Alan L. Bisno, Henry F. Chambers, E. Patchen Dellinger, Ellie J. C. Goldstein, Sherwood L. Gorbach, Jan V. Hirschmann, Sheldon L. Kaplan, Jose G. Montoya, James C. Wade, Practice Guidelines for the Diagnosis and Management of Skin and Soft Tissue Infections: 2014 Update by the Infectious Diseases Society of America, Clinical Infectious Diseases, 2014; 59(2): e10-52,
  • 11. Şen M, Balık ZB, Tunca M. Sociodemographic, clinical, biochemical and microbiological analysis of cellulitis patients: investigation of third level single center follow-up results. Ann Med Res. 2023;30(8):855-61.
  • 12. Ince N, Güçlü E, Sungur MA, Karabay O. Evaluation of neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, and lymphocyte to monocyte ratio in patients with cellulitis. Rev Assoc Med Bras. 2020;66(8):1077-81.
  • 13. Weiss G, Ganz T, Goodnough LT. Anemia of inflammation. Blood. 2019;133(1):40-50.
  • 14. Adamska-Tomaszewska D, Więcek S. The role of hepcidin in iron metabolism. Pediatria Polska - Polish Journal of Paediatrics. 2025;100(3):260-70.
  • 15. Zaid Y, Merhi Y. Implication of Platelets in Immuno-Thrombosis and Thrombo-Inflammation. Front Cardiovasc Med. 2022;9:863846.
  • 16. Sonmez, O, Sonmez M. Role of platelets in immune system and inflammation. Porto Biomedical Journal 2(6):p 311-4.
  • 17. Gros A, Ollivier V, Ho-Tin-Noé B. Platelets in inflammation: regulation of leukocyte activities and vascular repair. Front Immunol. 2015;5:678

Acil Servise Başvuran Selülit Hastalarında Klinik ve Laboratuvar Bulgularının Hastaneye Yatış ile İlişkisi

Yıl 2026, Cilt: 23 Sayı: 1 , 132 - 138 , 27.03.2026
https://doi.org/10.35440/hutfd.1800489
https://izlik.org/JA33MY98SL

Öz

Amaç: Selülit, deri ve subkutan dokuların bakteriyel enfeksiyonu olup acil servis başvurularının önemli bir kısmını oluşturmaktadır. Bu çalışmada, üçüncü basamak bir sağlık kuruluşunun acil servisine başvuran selülit olgularında hastaneye yatış gereksinimini öngörebilecek klinik ve laboratuvar parametrelerin değerlendirilmesi amaçlanmıştır.

Materyal ve metod: 01 Ocak 2019-01 Ocak 2025 tarihleri arasında Harran Üniversitesi Hastanesi Acil Servisine başvuran, 18 yaş üzeri selülit tanılı olgular retrospektif olarak incelendi. Hastaların demografik, klinik ve laboratuvar bulguları analiz edildi. Yatış gereksinimi ile ilişkili değişkenler lojistik regresyon analizi ile değerlendirildi. Çok değişkenli modelde bağımsız prediktör olarak kalan değişkenler için ROC analizi yapıldı.

Bulgular: Çalışmaya 162 hasta dahil edildi. Ortalama yaş 51,1±19,26 olup, olguların %57,7’si erkekti. Hastaların %52,5’i (n=85) hastaneye yatırılırken, %47,5’i (n=77) ayaktan takip edildi. Komorbiditeler arasında diyabetes mellitus (%22,1) ve hipertansiyon (%16,6) öne çıktı. Yatış gerektiren hastalarda inflamatuvar belirteçler anlamlı olarak daha yüksekti (p<0,05, hepsi için). Çok değişkenli lojistik regresyon analizinde C-reaktif protein (CRP) [odds raito (OR): 1,06; %95 güven aralığı (GA): 1,00-1,12; p=0,033)], hemoglobin (OR: 0,75; %95 GA: 0,59-0,95; p=0,016) ve trombosit (OR: 0,995; %95 GA: 0,991-0,999; p=0,014) yatış gereksiniminin bağımsız öngördürücüleri olarak saptandı. ROC analizinde, CRP’nin en yüksek AUC değerine sahip olduğu görüldü (AUC=0,692; %95 GA: 0,608-0,776; p<0,001).

Sonuç: Selülit hastalarında CRP, hastane yatışını öngörmede bağımsız bir belirteç olarak tespit edildi. Klinik değerlendirmeye eklenen laboratuvar parametreleri, yatış kararında destekleyici bir risk sınıflaması sağlayabilir.

Etik Beyan

Çalışma Helsinki Bildirgesi'ne uygun olarak hazırlanmış ve retrospektif çalışma olması dolayısı ile gerekli izin Harran Üniversitesi Hastanesi Başhekimliği ve Etik Kuruldan alındıktan sonra yapılmıştır.

Destekleyen Kurum

Destek alınan kurum yoktur.

Kaynakça

  • 1. Wiederhold AK, Cartuliares MB, Jeppesen K, Skjøt-Arkil H. Characteristics and antibiotic treatment of patients with cellulitis in the emergency department. Antibiotics (Basel). 2024;13(11):1021.
  • 2. Burian EA, Karlsmark T, Franks PJ, Keeley V, Quéré I, Moffatt CJ. Cellulitis in chronic oedema of the lower leg: an international cross-sectional study. Br J Dermatol. 2021;185(1):110-8.
  • 3. Lin V, Callado GY, Pardo I, et al. Diagnostic stewardship and dermatology consultation in cellulitis management: a systematic literature review and meta-analysis. Arch Dermatol Res. 2025;317:61. doi:10.1007/s00403-024-03515-x.
  • 4. Taira K, Wang M, Guo W, Kam O, Kaufmann T. Association of cellulitis with obesity: systematic review and meta-analysis. JMIR Dermatol. 2024;7:e54302.
  • 5. Nightingale R, Yadav K, Hamill L, et al. Misdiagnosis of uncomplicated cellulitis: a systematic review and meta-analysis. J Gen Intern Med. 2023;38(10):2396-404.
  • 6. Cutler TS, Jannat-Khah DP, Kam B, Mages KC, Evans AT. Prevalence of misdiagnosis of cellulitis: a systematic review and meta-analysis. J Hosp Med. 2023;18(3):254-61.
  • 7. Jacka J, Sierla R, Kilbreath SL, Dylke ES. A systematic review of cellulitis guidelines: the role of non-pharmacological management in preventing recurrence. Australas J Dermatol. 2025;66(6):321-8.
  • 8. Özçelik MN, Sayar MS, Aydın NN, et al. Clinical and inflammatory predictors of outpatient treatment failure in uncomplicated skin and soft tissue infections: a prospective multicenter study from Türkiye. BMC Infect Dis. 2025;25(1):1744.
  • 9. Raff AB, Kroshinsky D. Cellulitis: a review. JAMA. 2016;316(3):325-37.
  • 10. Dennis L. Stevens, Alan L. Bisno, Henry F. Chambers, E. Patchen Dellinger, Ellie J. C. Goldstein, Sherwood L. Gorbach, Jan V. Hirschmann, Sheldon L. Kaplan, Jose G. Montoya, James C. Wade, Practice Guidelines for the Diagnosis and Management of Skin and Soft Tissue Infections: 2014 Update by the Infectious Diseases Society of America, Clinical Infectious Diseases, 2014; 59(2): e10-52,
  • 11. Şen M, Balık ZB, Tunca M. Sociodemographic, clinical, biochemical and microbiological analysis of cellulitis patients: investigation of third level single center follow-up results. Ann Med Res. 2023;30(8):855-61.
  • 12. Ince N, Güçlü E, Sungur MA, Karabay O. Evaluation of neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, and lymphocyte to monocyte ratio in patients with cellulitis. Rev Assoc Med Bras. 2020;66(8):1077-81.
  • 13. Weiss G, Ganz T, Goodnough LT. Anemia of inflammation. Blood. 2019;133(1):40-50.
  • 14. Adamska-Tomaszewska D, Więcek S. The role of hepcidin in iron metabolism. Pediatria Polska - Polish Journal of Paediatrics. 2025;100(3):260-70.
  • 15. Zaid Y, Merhi Y. Implication of Platelets in Immuno-Thrombosis and Thrombo-Inflammation. Front Cardiovasc Med. 2022;9:863846.
  • 16. Sonmez, O, Sonmez M. Role of platelets in immune system and inflammation. Porto Biomedical Journal 2(6):p 311-4.
  • 17. Gros A, Ollivier V, Ho-Tin-Noé B. Platelets in inflammation: regulation of leukocyte activities and vascular repair. Front Immunol. 2015;5:678
Toplam 17 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Acil Tıp
Bölüm Araştırma Makalesi
Yazarlar

Cansu Doğan 0000-0001-7445-875X

Hüseyin Gürbüz 0009-0000-7190-4267

Mehmet Çelik 0000-0002-0583-929X

İpek Aslan 0009-0003-3297-2576

Mahmut İlhan 0009-0007-8300-8364

Gönderilme Tarihi 11 Ekim 2025
Kabul Tarihi 5 Mart 2026
Yayımlanma Tarihi 27 Mart 2026
DOI https://doi.org/10.35440/hutfd.1800489
IZ https://izlik.org/JA33MY98SL
Yayımlandığı Sayı Yıl 2026 Cilt: 23 Sayı: 1

Kaynak Göster

Vancouver 1.Cansu Doğan, Hüseyin Gürbüz, Mehmet Çelik, İpek Aslan, Mahmut İlhan. Acil Servise Başvuran Selülit Hastalarında Klinik ve Laboratuvar Bulgularının Hastaneye Yatış ile İlişkisi. Harran Üniversitesi Tıp Fakültesi Dergisi. 01 Mart 2026;23(1):132-8. doi:10.35440/hutfd.1800489

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